View the Latest: Obesity
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Nearly Four Million Medicare Beneficiaries Met the Eligibility Criteria in 2023 for the Medicare GLP-1 Bridge
Issue BriefMedicare has launched a temporary program covering GLP-1s for obesity for people with Medicare, known as the Medicare GLP-1 Bridge. This analysis estimates the number of Medicare Part D enrollees who could potentially qualify for the Bridge program by meeting all of the eligibility criteria, based on claims data from 2023.
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What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge
Issue BriefThis brief describes current coverage of GLP-1s in Medicare and Medicaid, the Centers for Medicare & Medicaid Services’ (CMS) efforts to expand access and lower costs for GLP-1s through temporary demonstration programs including the BALANCE Model, and potential impacts on beneficiaries and program budgets.
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5 Key Facts About Medicaid Prescription Drugs
Issue BriefTo provide context for emerging debates about federal actions to address prescription drug costs, this issue brief highlights five key facts about Medicaid prescription drug coverage, payment, and administration.
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Recent Trends in Medicaid Outpatient Prescription Drugs and Spending
Issue BriefThis issue brief describes recent trends in the number of Medicaid outpatient prescriptions and the spending on those drugs and examines the implications of recent federal actions on future trends.
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The IRA Has Improved Coverage of Drugs Selected for Medicare Price Negotiation
Issue BriefThe Medicare drug price negotiation program could improve coverage of drugs selected for negotiation for Medicare beneficiaries because the law requires all Medicare Part D plans to cover each of the selected drugs, including all dosages and forms, when negotiated prices take effect. This analysis examines 2026 Medicare Part D formulary coverage of drugs selected for negotiation to measure the effect of the IRA's coverage requirement.
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Recent Trends in GLP-1 Use and Spending in Medicare
Issue BriefAhead of the Trump administration’s planned expansion of Medicare coverage for GLP-1s to treat obesity through temporary models and the availability of Medicare’s negotiated price for certain GLP-1 products beginning in 2027, this analysis examines CMS’s Medicare Part D claims data from 2019 to 2024 to document the increase in the number of beneficiaries being treated with GLP-1 drugs and the growth in Medicare spending and claims for these drugs.
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Medicaid Coverage of and Spending on GLP-1s
Issue BriefThis brief discusses the current landscape of Medicaid GLP-1 coverage and examines recent trends in Medicaid prescriptions and gross spending on GLP-1s.
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As ACA Deadline Approaches, Some Price-Sensitive Consumers May Consider Switching to Short-Term Plans
Quick InsightsAs the ACA open enrollment deadline approaches amid the expiration of the enhanced premium tax credits, nearly six in 10 Marketplace enrollees say they would not be able to afford $300 more in annual health care costs, which may lead some to alternative coverage products, such as short-term plans, a type of private coverage that tends to have lower premiums but few consumer protections and limited benefits.